A nurse is teaching a client who has a new prescription for diazepam. Which of the following information should the nurse include in the teaching?

A. "Do not drink alcohol while taking this medication": Disulfiram is a medication used to deter alcohol consumption by producing unpleasant effects, such as nausea, vomiting, and flushing, if alcohol is consumed. Therefore, it is crucial for the client to abstain from alcohol while taking disulfiram to avoid these adverse reactions.

B. "Do not crush this medication before swallowing": While it is generally important not to alter the formulation of medications unless instructed by a healthcare provider or indicated in the medication's instructions, crushing disulfiram is not typically a concern. However, the primary focus of disulfiram therapy is the avoidance of alcohol, rather than specific administration instructions.

C. "Avoid grapefruit juice while taking this medication": Grapefruit juice is known to interact with certain medications by inhibiting cytochrome P450 enzymes in the liver, affecting drug metabolism. However, there is no significant interaction between disulfiram and grapefruit juice. Therefore, this information is not relevant to disulfiram therapy.

D. "Take this medication with food": Disulfiram is typically taken on an empty stomach, as food can interfere with its absorption. Therefore, advising the client to take disulfiram with food is not accurate and may compromise its effectiveness. The primary concern with disulfiram therapy is adherence to abstinence from alcohol.

A. Insert the needle slowly and gently.

This statement is generally true for most injection techniques, including the Z-track method. Slow and gentle insertion helps minimize discomfort for the client and allows for better control over the needle's placement. However, the specific speed of insertion may vary depending on the nurse's technique and the client's skin condition.

B. Pull the skin 1.3 cm (1/2 inch) to the side.

This statement is correct. The Z-track technique involves pulling the skin laterally (to the side) by approximately 1.3 cm (1/2 inch) before inserting the needle. This lateral displacement of the skin creates a zigzag pathway for the medication, which helps prevent leakage or tracking of the medication along the injection site.

C. Aspirate for 5 to 10 seconds.

Aspiration, or pulling back on the plunger of the syringe after needle insertion, is not typically recommended for intramuscular injections, including those using the Z-track method. Aspiration may increase the risk of tissue trauma or damage to blood vessels. Since the Z-track technique is designed to minimize medication leakage into the subcutaneous tissue, aspiration is usually unnecessary.

D. Use a 45° angle of insertion.

The angle of insertion for the Z-track technique is typically 90 degrees (perpendicular) to the skin surface rather than 45 degrees. This angle allows for proper depth penetration into the muscle and ensures adequate delivery of the medication into the muscle tissue.